Is there an association between dental caries, fluorosis, and molar-incisor hypomineralization?

Ana Paula Dias Ribeiro,Soraya Coelho Leal,Leandro Augusto Hilgert,Marília Bizinoto Silva Duarte,Vanessa Reinaldo Carvalho,Eliana Mitsue Takeshita

doi:10.1590/1678-7757-2020-0890

Ana Paula Dias Ribeiro, Soraya Coelho Leal + Show 4 more

Open Access

https://doi.org/10.1590/1678-7757-2020-0890

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Abstract

Objective:This cross-sectional study aimed to determine the prevalence of dental caries, dental fluorosis, and molar-incisor hypomineralization, and their associations in a group of Brazilian schoolchildren.Methodology:Adolescents (n=411) were evaluated by two calibrated examiners for dental caries (DC), dental fluorosis (DF), and molar-incisor hypomineralization (MIH) using the CAST (Caries Assessment Spectrum and Treatment) instrument, Thylstrup and Fejerskov (TF) index, and MIH Severity Scoring System (MIH-SSS), respectively. Descriptive statistics, chi-square tests, and logistic regression were used for statistical analysis.Results:The sample comprised 42.75% boys and 57.25% girls. The prevalence of DC in permanent dentition was 94.75%, of which 29% were represented by dentin lesions. For DF, a prevalence of 40.75% was observed, with 69.32% mild, 12.88% moderate, and 17.79% severe. A positive association between the source of water and fluorosis was detected (p=0.01). The prevalence of MIH was 18%. Thirty adolescents (41.7%) presented with severe MIH. No association was found between DF or MIH and dentin DC or between MIH and DF at the individual level. However, a significant negative relationship was detected between DF and dentin carious lesions ( p <0.005) and DF and MIH ( p <0.00001) at the tooth level, whereas a positive association was observed between MIH and dentin carious lesions ( p <0.00001). A positive association was also observed between the severity of both conditions ( p <0.00001). Mild DF was the most prevalent problem observed. Cases of teeth with mild MIH were the most predominant in MIH-affected teeth.Conclusions:No association was observed among the dentin carious lesions, MIH, and DF at the participant level. However, a positive association between MIH and dentin carious lesions was found at the tooth level, whereas MIH, DF, and DF and dentin carious lesions showed a negative relationship.

Highlights

Tooth structures can be damaged before and/or after tooth eruption
A significant negative relationship was detected between dental fluorosis (DF) and dentin carious lesions (p
No association was observed among the dentin carious lesions, MIH, and DF at the participant level

Summary

Introduction

Tooth structures can be damaged before and/or after tooth eruption. Before eruption, disturbances to ameloblasts during amelogenesis may affect the appearance and structure of the enamel of both primary and permanent teeth, an event described as developmental defects of the enamel (DDE). After eruption, the most frequent problem affecting the integrity of children’s teeth is dental caries (DC). both dental caries and DDEs can be observed on the same tooth, with evidence showing that DDEs may be a risk factor for dental caries onset.4,5DDEs are classified into qualitative and quantitative defects. Disturbances to ameloblasts during amelogenesis may affect the appearance and structure of the enamel of both primary and permanent teeth, an event described as developmental defects of the enamel (DDE).. The most frequent problem affecting the integrity of children’s teeth is dental caries (DC).3 Both dental caries and DDEs can be observed on the same tooth, with evidence showing that DDEs may be a risk factor for dental caries onset.. DDEs are classified into qualitative and quantitative defects. Qualitative defects result from an alteration during the enamel mineralization process. This is observed as opacities that can be demarcated or diffuse and can vary in color, from white/yellow to brown, without enamel thickness impairment.. This is observed as opacities that can be demarcated or diffuse and can vary in color, from white/yellow to brown, without enamel thickness impairment. On the other hand, quantitative defects are a consequence of an inappropriate deposition of the organic matrix, producing hypoplastic areas in which the enamel was not formed; this absence of enamel can lead to morphological and functional impairment of the affected teeth.

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